Aplastic anemia is characterized by peripheral pancytopenia and a hypocellular bone marrow. The treatment of choice is allogeneic bone marrow transplantation from an HLA-matched sibling. Unfortunately, the majority of affected patients are ineligible for this procedure because of lack of a suitable donor, advanced age, or lack of financial resources. Currently, the best treatment for these individuals is immunosuppression. in protocol 90-H-146 we are trying to optimize the immunosuppressive regimen by combining four days of anti-thymocyte globulin (ATG) and six months of cyclosporine A. We have enrolled a total of 53 patients and are in the process Of analyzing the data for publication. Patients are admitted to the NHLBI Hematology Branch clinical service located on 2W. Attending responsibilities rotate among the NHLBI staff as well as Clinical Center staff, including Transfusion Medicine. There was no attending from CPD last year, but three of the Hematology senior staff are scheduled to attend in the coming year. Patients are cared for by Hematology fellows. All data analysis is performed by Dr. Rosenfeld.